Healthcare professionals and partners

The NTA expects all service users to have a written care plan which is developed and reviewed on a regular basis with them. NTA guidance on effective care planning includes:

Care Planning Practice Guide (2006).

Care planning maps (to support the practice guide) (2006).

Good practice in care planning (2007).  

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The NTA published guidance in 2006 on commissioning pharmaceutical services for drug users, in partnership with the Royal Pharmaceutical Society of Great Britain (RPSGB), Pharmaceutical Services Negotiating Committee (PSNC) and Pharmacy Misuse Advisory Group (PharMAG).

Best Practice Guidance for Commissioners and Providers of Pharmaceutical Services to drug users helps commissioners and pharmacists to deliver better pharmaceutical services to drug users across England. 

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Effective drug treatment involves a spectrum of care - from counselling and detoxification, to prescribed medication and aftercare - depending on the needs of a particular client.
Prescribing medication is an important element of many drug treatment programmes.

Professor John Strang is chairing a group looking at how the range of treatments used in drug addiction can have a clearer recovery orientation. His interim report on the group’s work and recommendations was published in July 2011. Further work is expected to be published early in 2012. More information on the group and its work is at http://www.nta.nhs.uk/news-expertgroup-2010.aspx.

The NTA documents below provide guidance on prescribing services, and their role in structured and co-ordinated care.

• Models of Care for Treatment of Adult Drug Misusers: Update 2006 (section 9.4)
• Models of Care part 2, 2002 (section 2.5 - Community prescribing)
• Prescribing Services for Drug Misuse (2003)
• Injectable Heroin (and Injectable Methadone) Potential roles in drug treatment (full report)
• Injectable Heroin (and Injectable Methadone) Potential roles in drug treatment (summary)
• Nurse Prescribing in Substance Misuse (Feb 2005, updated May 2005)

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By engaging and retaining clients in effective treatment, it is anticipated that more clients will achieve their treatment goals and leave drug treatment in a planned way.

Towards successful treatment completion:

• examines the reasons why clients may not complete drug treatment and examines factors involved in successful, planned discharges
• reviews the research on measures designed to improve engagement and retention in treatment
• gives examples of good clinical practice aimed at improving treatment effectiveness and successful treatment outcomes.

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The National Institute for Health and Clinical Excellence (NICE) has produced several drug and alcohol specific pieces of guidance. Links to these and other related guidance can be found below.

Drug treatment specific NICE guidance:

• Drug misuse: psychosocial interventions (NICE clinical guideline, CG51).
• Drug misuse: methadone and buprenorphine maintenance (NICE technology appraisal, TA114)
• Drug misuse: opioid detoxification (NICE clinical guideline, CG52)
• Drug Misuse: naltrexone for the management of opioid dependence (NICE technology appraisal,TA115)
• Psychosis with coexisting substance misuse (NICE clinical guideline, CG120)
• Pregnancy and complex social factors (NICE clinical guideline, CG110)
• Interventions to reduce substance misuse among vulnerable young people (NICE public health guideline, PH4)
• Needle and syringe programmes: providing people who inject drugs with injecting equipment (NICE public health guideline, PH18)
• A NICE quality standard on drug use disorders is currently in development and is expected to be published in December 2012.
  See http://www.nice.org.uk/guidance/qualitystandards/indevelopment/DrugUseDisorders.jsp

 Alcohol specific NICE guidance:

• Alcohol-use disorders: physical complications (NICE clinical guideline, CG100)
• Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (NICE clinical guideline, CG115)
• Alcohol-use disorders - preventing harmful drinking  (NICE public health guideline, PH24)
• Alcohol dependence and harmful alcohol use quality standard (NICE quality standard)

•  Related NICE guidance but not drug or alcohol specific:
• Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults (NICE clinical guideline, CG113)
• Hepatitis C - pegylated interferons, ribavirin and alfa interferon (NICE technology appraisal,TA75)
• Hepatitis C - peginterferon alfa and ribavirin (NICE technology appraisal,TA200)
• Hepatitis B (chronic) - adefovir dipivoxil and pegylated interferon alpha-2a (NICE technology appraisal,TA96)

The Effectiveness of Psychological Therapies on Drug Misusing Clients

• Roles and Responsibilities of Doctors in the Provision of Treatment for Drug and Alcohol Misusers (currently being revised, due 2011)

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